Healthcare Provider Details

I. General information

NPI: 1902018765
Provider Name (Legal Business Name): MARGARET MARY HICKEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST #1063
CHICAGO IL
60612-3841
US

IV. Provider business mailing address

1 WESTBROOK CORPORATE CTR #240
WESTCHESTER IL
60154-5701
US

V. Phone/Fax

Practice location:
  • Phone: 312-243-4244
  • Fax: 312-243-2744
Mailing address:
  • Phone: 708-236-2673
  • Fax: 708-236-2773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: